title: Microstructural brain tissue damage in metabolic syndrome.
abstract: OBJECTIVE
  We investigated the association between metabolic syndrome risk factors and brain tissue integrity, as assessed by magnetic resonance imaging.
  
  
  METHODS
  From the Leiden Longevity Study, which is a community-based study of long-lived subjects, their offspring, and partners thereof, 130 subjects (61 men; mean age 66 years) were included. A metabolic syndrome score was computed by summing the individual number of components according to the Adult Treatment Panel III criteria. We performed linear and logistic regression analysis and used standardized β-values to assess the association between metabolic syndrome and brain macrostructure (brain volume and white matter lesion load, lacunar infarcts, and cerebral microbleeds) and microstructure (mean magnetization transfer ratio [MTR], MTR histogram peak height, fractional anisotropy, and mean diffusivity [MD]). Linear and stepwise regression analysis was performed to identify the individual contribution of one metabolic syndrome parameter adjusting for the four other parameters. Models were adjusted for age, sex, and relation to long-lived family.
  
  
  RESULTS
  Brain macrostructure was not associated with metabolic syndrome. In contrast, metabolic syndrome was associated with decreased gray (β = -0.3 P = 0.001) and white matter peak height (β = -0.3, P = 0.002) and increased gray matter MD (β = 0.2, P = 0.01, P = 0.01). Serum HDL cholesterol (β = 0.22, P = 0.012), triglycerides (β =-0.25, P = 0.002), BMI (β =-0.2, P = 0.014), and diastolic blood pressure (β = -0.17, P = 0.047, and β = -0.23, P = 0.009, for gray and white matter, respectively) were independent factors in these changes in brain microstructure.
  
  
  CONCLUSIONS
  In early manifest metabolic syndrome, brain tissue decline can be detected. Serum HDL cholesterol, triglycerides, BMI, and diastolic blood pressure were independent factors in brain tissue integrity.
authors.affiliation: Corresponding author: Michiel Sala, m.l.sala@lumc.nl.
authors.forename: Michiel
authors.initials: M
authors.lastname: Sala
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.forename: Annette
authors.initials: A
authors.lastname: van den Berg
authors.forename: Irmhild
authors.initials: I
authors.lastname: Altmann-Schneider
authors.forename: P Eline
authors.initials: PE
authors.lastname: Slagboom
authors.forename: Rudi G
authors.initials: RG
authors.lastname: Westendorp
authors.forename: Mark A
authors.initials: MA
authors.lastname: van Buchem
authors.forename: Anton J M
authors.initials: AJ
authors.lastname: de Craen
authors.forename: Jeroen
authors.initials: J
authors.lastname: van der Grond
mesh_terms: D000368:Aged; D001921:Brain / Q000648:ultrastructure*; D003071:Cognition; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D024821:Metabolic Syndrome / Q000473:pathology* / Q000523:psychology; D008875:Middle Aged